LAPAROSCOPIC MINOR PANCREATIC RESECTIONS (ENUCLEATIONS/ATYPICAL RESECTIONS). A LONG-TERM APPRAISAL OF A SUPPOSED MINI-INVASIVE APPROACH.

Introduction Few retrospective, small-sized, often multicentric studies show encouraging results of laparoscopic minor pancreatic surgery, but do not allow for an evaluation of feasibility and effectiveness. Aim The purpose of the paper is to evaluate the results of laparoscopic pancreatic minor resections (LMPR), including atypical resections and enucleations. Material and Method Outcome of all consecutive patients undergoing LMPR in a Tertiary Care University Hospital specializig in the laparoscopic approach to solid organs (I.M.M., Paris – France), was retrospectively evaluated by the analysis of operating time, blood loss, conversion, morbidity, stay and late outcome. Results Thirthy-three patients underwent LMPR (29 enucleations and 4 atypical resections) for various affections. Conversion rate was 21%, mean operating time 189 minutes, and mean blood loss 133 ml. Morbidity was 60%; 10 patients (30%) presented a pancreatic fistula. Pancreatic fistula was independent of type of resection, technique of pancreas section, management of enucleated surface and somatostatine administration. Median stay for enucleations was 18 days. Mean follow up was 61 months. Conclusions Laparoscopic pancreatic enucleations are feasible and safe, with no mortality, no lengthening of operating time and high success rate; conversely, it does not imply a reduction in complications and hospital stay at the present state of the art.